US death toll rises in meningitis outbreak

The death toll from a worsening meningitis outbreak tied to a contaminated drug has risen to eight while the number of people infected in the United States is up to 97, health officials said Monday. Cases have been identified in nine states, with the hardest-hit being Tennessee, where 35 people have been diagnosed with the fungal infection and four have died, the Centres for Disease Control and Prevention (CDC) said. Michigan is the second-most infected state, with 21 cases and two deaths so far. Cases have also been noted in a vast region spanning Florida, Maryland and Minnesota. In its latest bulletin, the CDC urged doctors to "actively contact" any patients who received doses of the potentially contaminated steroid injection - typically used to treat back pain - as far back as May 21. The public health agency said symptoms of fungal meningitis, which has a very long incubation period, include fever, new or worsening headaches, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site. Several patients also suffered strokes. The rare infection - which inflames the protective membranes covering the brain and spinal cord - often goes undetected until it is too late because its flu-like symptoms can be mild at first. But meningitis is not contagious in this form. Early detection and treatment - requiring a hospital stay to administer intravenous anti-fungal medications - can prevent permanent damage. A multi-state investigation is underway to determine the cause of the outbreak, but the Food and Drug Administration said it had detected a fungal contaminant in a sealed vial of the drug produced by the New England Compounding Centre in Massachusetts. While further testing is required to confirm it was the source of the outbreak, the company has issued a voluntary recall of all of its products and shut down all operations. Officials posted a list of the 75 health care facilities in 23 states that received lots of the contaminated drug which can be seen here.